Job Summary

A healthcare company is searching for a person to fill their position for a Remote Healthcare Fraud Investigator I in Pittsburgh.

Must be able to:

• Investigate assigned cases, collecting, researching and analyzing claim data
• Use appropriate system tools and databases for analysis of data
• Prepare final case reports and notification of findings letters to providers

Qualifications for this position include:

• This position will require local travel within the Southwestern PA area
• Must live within 60 miles or 1 hour of our office in Seven Fields, PA
• Must have a BA/BS
• Experience contracting or Claim Operations, law enforcement
• Communication skills, both oral and written required
• 2+ years related experience preferably in healthcare insurance departments